Neck pain is a multifactorial disease, and is a major problem in modern society. Patients with NCNP usually have alterations in cervical proprioception and PS. They may also develop symptoms such as dizziness or vertigo. A recently published study shows that patients with NCNP suffer greater sensations of stunning and lack of proprioception than patients with benign paroxysmal vertigo.
This study will be a randomized controlled trial and will be conducted on general population in Gujrat. Non-probability convenient sampling will be used to collect the data. Sample size of 48 subjects with age group between 25-45 years will be taken. Data will be collected from the patients having present complaint of Nonspecific Neck pain. Outcome measures will be taken using Numeric pain rating scale (NPRS) for pain, Neck disability index (NDI) for measuring disability and goniometer for range of motion (ROM). An informed consent will be taken. Subjects will be selected based on inclusion and exclusion criteria and will be equally divided into two groups by random number generator table. Both the Groups will receive standard physical therapy, while Group A will receive bruegger's exercises and Group B will receive Upper thoracic mobilization. Outcome measures will be measured at baseline then after 4 weeks(post). Data analysis will be done by SPSS version 21.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
48
Bruegger's Exercise: The position will be held for 10 second at first session and then there will be an increment of 2 seconds during each session. Upper Thoracic Mobilization: Upper thoracic (T1-T6) mobilization (Maitland mobilization (Grade I, II and III; PA glide) applied in prone lying position from via spinous process. Amount of treatment will be 3-4 mobilizations for a vertebra for 30 seconds approximately.
Isometric exercises will be done for flexors, extensors, rotators, and lateral flexors of the neck. Isometrically contracting working muscle for 5 seconds against patients own hand, which was placed in compliance with the working muscles, with a total of 10 repetitions. Passive stretching will apply to Upper trapezius, Levator scapulae, Sternocleidomastoid, Scalene, Pectoralis major and minor muscle for 3-5 repetition 10 with 20-30 second hold. Intensity of exercise will be prescribed according to patient's tolerance level. Duration of stretch will 15 to 30 seconds, 3-5repetition and for 10 minutes. Postero-anterior Maitland mobilization (Grade I \& II) for C1-C2, Maitland lateral PA glide (Grade-III \& IV) for C3-C6. Time of oscillations will be two or three oscillations in a second for one to two minutes.
Medical and Rehabilitation Center, Gujrat
Gujrat, Punjab Province, Pakistan
Numerical Pain Rating Scale (NPRS)
Patient level of pain will be assessed using the NPRS scale. The NPRS was used to capture the patient's level of pain. Patients were asked to indicate the intensity of their current pain level using an 11-point scale, ranging from 0 (no pain) to 10 (worst pain imaginable).
Time frame: upto 4 weeks
Neck Disability Index (NDI)
Patient level of Disability will be assessed using NDI. The NDI is a self-report questionnaire with 10-items: pain intensity, personal care, lifting work, headaches, concentration, sleeping, driving, reading, and recreation. The response to each item is rated on a 6-point scale from 0 (no disability) to 5 (complete disability). The numeric responses for each item are summed for a total score ranging between 0 and 50; however, some evaluators have chosen to multiply the raw score by 2 and then report the NDI on a 0-100% Higher scores represent increased levels of disability.
Time frame: upto 4 weeks
Universal Goniometer (UG)
A large UG having 12-inch arms and full-circle plastic body will be used for measuring ACROM..It will be used to measure cervical AROM: flexion, extension, lateral flexion, and rotation.
Time frame: upto 4 weeks
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